Experiences of health professionals in early parenthood

Yeah there's just so much pressure. I even find in places like Facebook and the Australian Breastfeeding Association and all those parenting websites, I think they sort of still put that pressure on - that breast is best and all that sort of thing and that doesn't help at all.

They went through exactly the same thing in hospital and just found the attitudes of the midwives and the nurses in there to be kind of aggressive. Aggressively promoting breastfeeding and if you feed your child formula you're poisoning them or something. My paediatrician was actually the only voice of reason and he came in, he said, "You know it's over-rated, don't - you know don't let them pressure you", and I sort of remember him saying that to me but not sort of quite believing it because I was still in that sort of fog of guilt and pain and being afraid to feed him because. But he was the only voice of reason.

He just went into like the medical side of it and said, "It is beneficial but sometimes it isn't towards the child and you can still sort of pick up a lot of diseases and antibody" - he just went into the whole medical side of it which I can't really [laughs] quite remember but I know it was sort of to do with antibodies in some kids can actually develop an allergy towards breastmilk and so he said, "It's not always beneficial and formula - they can thrive just as well".

Yeah he was really good. He was - I still see him. Like I still take [son's name] to that paediatrician because he's really good.

The child and maternal health centre I accessed wasn't very good, they were also breastfeeding Nazis and didn't help me much when I went to them a couple of times whenever I was feeling very homesick it just happened to be whenever I had check-ups, I didn't go specifically for that reason, but whenever I had check-ups. And I was quite open one of the times and said, "I'm really struggling here because I miss my family", and they didn't give me anything back.

There was one time as well in the very early stages that I mentioned to one of the nurses that my partner had done a bottle for me overnight and I'd got a bit more of a sleep. And this nurse nearly fell off her chair saying that I was going to dry up, and not to make a habit of that.

So I think a better understanding from child maternal health nurses would help - a bit more warmth from them, like person skills - I told them I was having problems with [son's name] sleeping - she got on the computer or website, that www.raisingkids.net, which is a great website, I have been on it, it does have great advice. But the nurse would put the website up and show me where the sleep section was. That's never going to help me, [laughs] so I think it would have been good to have a more caring environment within that health service.

I did have a maternal health nurse come over. So when we left the hospital with our daughter, I guess they were quite opinionated about they didn't think our midwife had offered us very good post-birth care because we'd wound up in hospital. So they said I needed to see this local maternal health nurse who phoned me and came over to our house. And it was a really horrible experience. Like she was really judgmental about us having a home birth and again insinuated that our midwife didn't provide us with very good care, which I really objected to because I just loved our midwife and I think she did an amazing job with our birth and afterwards she was so supportive.

It just went the way that it went and it was no one's fault. So found myself sort of justifying a lot, which I don't really do. So I didn't see them again, but we do have a GP who we - who I was seeing - I should have mentioned that earlier - who I was seeing in conjunction with my midwife during my pregnancy. And so he's continued to see the baby, yeah, at her various check-ups.

So with him, did he ever ask you how you were going yourself?

Yes, I think maybe the first time he met the baby was when she was six weeks old and he did ask about that. And I sort of downplayed I guess my experiences. Because my partner kept saying to me that he thinks I have postnatal depression and I guess knew enough about depression to know that that's not what was happening. And I kept saying to him, "I'm not depressed, I'm upset". And I still say that and so I said the same to the GP. I said, "You know, my partner thinks I've got depression and I don't think that. I think there's been these things that have happened that have been acutely stressful and this has been my reaction." So the GP agreed with me on that. And I guess it explained what postnatal depression was, so that was the end of that.

And then it was only when I went back to him when the baby was six months old that I um expressed some concern and asked for a referral to a psychologist. He again said he didn't think that I was depressed. And just when I explained the issues that I was dealing with - because there's, you know a host of other issues as well as the parenting related stuff. When I explained that to him, he said, "You know, that that's a reasonable thing to be feeling", and that he would agree that I need some assistance with helping with that.

It's very good in here, the [maternal and child] nurse, because you know about your child, how they grow and they're normal and when my son is a little bit underweight when the nurse told me I'm very happy because I know and I still give him some special food to grow bigger. In my country [nothing] like this, health nurse or something. When you are taking the vaccine this is good but the government do not tell you to go and vaccine. Here I'm very happy, very good, you know about everything. I'm very happy because I know but when I'm worried about something then I ask the nurse, "Why is it like this?" and sometimes [my son] always knows something he wants. I don't give him and then [he] shout, "Oh, oh!" [laughs]. I asked her and she said, "Yeah this kid is normal, nothing happens". Something I'm worried and then I ask her. I'm very happy when I talk to her. Yeah when I'm sad or worried about something then I ask, they give me a question, I'm happy.

Oh, look it was - we went through the normal channels with maternal health and that kind of thing, but my main focus was the - the paediatrician assistance that I had with him until he was two, so I didn't even attend all of our - our maternal health visits, which was wrong, but I knew I did have that - did know that every couple of months I was going to the paed, so my focus was on his health and not on my own. So I think maybe if I'd gone to those maternal health sessions then - then perhaps they would have - would have picked up on something.

And I did go to them until he was about six months, but - look, the focus on those sessions are, of course, on the baby, as they should be. The area that we're in, the socio- demographic that the maternal health centre where I am, there's a lot of focus on whether the baby is in an abusive environment. So, there's a lot of focus on that, and not so much on the mother's mental health. When they delved into the mothers' mental health it was more along the lines, "Is your partner violent with you? Are you in an abusive relationship or is there abuse in the house?"

And they were more so than emotional issues, and they need to because of our particular area, and the area that we live in, they need to be focussed on those things, but someone who's having emotional issues and doesn't have any abusive issues probably slips through the cracks a little bit.

Maybe in terms of lessons learned and health professionals I guess, you know, GPs being aware of that 'cause they're generally the ones that or obstetricians or whatever that you've gone through and checking in maybe at that six week check-up and the nurses as well I guess play an important role there too. A friend of my said, "What's maternal about maternal child and health?" I think that has changed since having our daughter. I think there's a visit now that's just about you, I think it's the postnatal depression screen.

So yeah, I guess that's, that's good that that's incorporated now, but it could sort of I think be more of a conversation, because you're sort of handed a screen and, yeah, that would be good to have a bit more of a, I think, maybe the nurses need a bit more training in that regard.

But in terms of getting it right, in terms of the support my experience was interesting in that after doing that screen, it obviously came out that I had had a bit of a hard time and the nurse said, "Well make sure you talk to your GP about that." And then I'd seen a GP - lactation consultant about some breastfeeding issues and she said, "Well make sure you talk to your nurse about that". So it's sort of like, who is taking responsibility? Like everyone knows how to diagnose and to be aware, but what comes next?

I mean that diagnosis or that label or you know the awareness that you might have issues, is the first step, but in some ways, it can leave you feeling even worse if there's no follow-up from that I think. So, I suppose that might be something that might be helpful to look at, how we can encourage better skills in people that are in contact with mums. And I think, well for me, I guess for most mums, your nurse, your GP and any other you know, specialist is, are the, they're sort of - what's it called - forefront, direct service providers that you might come in contact with, apart from other mums.

So for me, that, that would have meant, a medical profession that was better trained at asking some of those questions - not necessarily giving me a postnatal depression screen or pre-natal, which is now where they're into. But it might have been just saying, "How are you going?" But within a 15 minutes appointment, in the public system, there's no scope for that.

The second time round, different mental health nurse who I just seemed to get along. The first one was an old lady. Didn't have children. I didn't really relate to her, nor did many others that I know of. I don't think - you know just there was no connection there, so there was no real free talk and I think I felt that if I'd say something to her, I'd be showing signs of failure. And you know I just - maybe with her I just couldn't do that. It was just like almost talking to my mother or something. Like, I can't show signs of failure. Not that I ever felt that I you know couldn't with my mother, but you sort of feel like an older person you don't want. You know, you've got a new child, you're a new mum, you don't want to be a failure.

With my second child, different maternal health nurse. Younger, lovely, had a great rapport with her, beautiful lady. And got along with her really well and was able to open up to her. Sort of straight away we went through the test. I answered that truthfully rather than emotionally, rather than organising where my answers were. I answered it truthfully and I talked to her. And actually she wrote a letter for me to say that you're suffering from postnatal, could I also - at that time the older daughter was in crèche - could we have some extra funding so the older daughter could go to crèche a little bit more.

Instead of only three days a week I think she organised it for maybe four days a week, or two to three. I can't remember.

So she actually wrote the letter and organised it and had a letter for me to give to my GP as well. So she was right on to it, and I was able to be open with her and say, "Yes I am. Yeah I am suffering from it."

But you know, it's kind of funny. All the health professionals are kind of geared up in their head to what you do with one baby and one child. And because you're only usually dealing with one - or they're dealing with children at different ages - and most people only have one at a time. So everything, all the ideas and rules that you learn, they always gear it to that and then they've got to do a second take and go, "Oh", you know.

I mean, even when we've gone to see the child maternal nurse, we'd have one appointment and both the girls, and sometimes she'd go "Oh my goodness, I've forgotten to write in the second book." Because we've got to go through everything twice. So they'd miss things because she'd go, "I've already done that". And she's only seeing them for half an hour in an appointment and I've got them every day, all day and I've got to go, "Oh my goodness, have I done both?"

When we went to sleep school, the technique is the baby is screaming, you put them into bed and you start doing a double pat and then when they slow down, you pat slower and one hand. And so I go, "How am I going to do that with two?" So I was told - because the room they put us in, in hospital they had the cots sort of on either side of the room. They'd say, "Oh well, go in, see who is crying the loudest and calm that one down and then go calm that one down", and my jaw just dropped and I'm thinking, 'Absolutely, they've got no idea'.

We have their cots together and I would pat them both at the same time. So it means I've got to lean over the cot and put all that pressure on my lower back and pat them both simultaneously.

I don't know how many people they had in hospital. But they had at least one set of twins every week, they told me. When we were there they had two sets of twins. So it's a much higher percentage of twins and multiples in that program, than there are children in the general population, because it's like one in 200 births or something. You know, there might have been maybe between 20 and 50 people, families in there, so a much, much higher.

Yet they're not really thinking about, to that kind of degree, of the extra challenges of two.

Then when we came home we had some issues with her, breastfeeding, and that was really hard to find support for that in our area, because we sort of dealt with the outpatient clinics.

I ended up with cracked nipples and she was vomiting blood and it was horrible. And I rang them up and I said, "Oh, can I speak to the lactation consultant? " And they asked me where I lived and then they said, "Oh, sorry, we can't help you. Bye". And hung up. And I was really shocked by that. I was really shocked that they would say that they just weren't going to do it.

And ended up ringing - there's like the family health nurse that works out of the town - next town across. And she came to our house and was really, really good. She was really helpful. But it was hard to find someone who would actually be willing to help, which is really odd. Yeah, I don't know what I would do if I had another child.